Lifestyle changes in New Yorkers after September 11, 2001 (data from the post-disaster Heart Attack Prevention Program)

It has been shown that cardiac event rates escalate under acute life stressors, such as war and natural disasters.(1-3) The mechanism by which psychological stress promotes cardiovascular disease is believed to be due to changes in behavior and lifestyle, as well as direct pathophysiologic effects of stress.(4) The terrorist attacks against the United States on September 11, 2001, presented a unique situation in which New Yorkers and other Americans across the country experienced substantial symptoms of stress.(5) We hypothesized that New Yorkers would have adverse lifestyle responses to the terrorist attacks, and that these responses would be more pronounced in people who were directly involved or had family members and close friends present at the World Trade Center on September 11. We also sought to determine whether lifestyle changes normalized within 4 months.